Alveolar bone grafting in a cleft patient has functional and esthetic considerations. Patients with bilateral cleft deformities greatly benefit from bone grafting because it provides the arch continuity and stability these patients lack, especially in the premaxilla. Functional objectives are to close the nasolabial fistula, facilitate tooth eruption at the cleft site to allow orthodontic treatment and further prosthodontic rehabilitation, support the nasal alar base, improve oral hygiene and periodontal health, and stabilize the premaxilla in patients with bilateral cleft. Esthetic objectives are to improve alar base support of the nose by grafting the deficient piriform region, address nasal asymmetry, form a proper dental arch for prosthetic and dental tolerance, and improve the patient’s smile.

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Bone grafting of the cleft maxilla and alveolar ridge in patients with bilateral cleft lip and palate is indicated to achieve several key objectives: restoring the structural integrity of the alveolar arch, providing bony support for adjacent teeth, facilitating eruption of permanent canines, and improving the overall the ooverall esthetic and functional outcome of the

Cleft